DOI: 10.31038/IJNM.2020111

Abstract

There is growing evidence that under-graduate nursing students are demonstrating inappropriate and uncivil behaviour towards academics which is also reported as harassment and contra-power harassment. Harassment is unwanted behaviour which an individual finds offensive or which makes them feel intimidated or humiliated and unwanted behaviours include verbal or written words of abuse such as offensive emails, comments on social media network sites, stalking and sexually motivated behaviours. Contra-power harassment is defined as the harassment of individuals in formal positions of power and authority by those that are not. One of the most cited reasons for inappropriate behaviour by undergraduate students is related to grading of course work and course progression, but literature relating to what extent this is occurring towards nurse academics is nominal.

Aim: The aim of this study is to understand the extent to which nursing academics experience inappropriate, uncivil or harassing behaviour deemed as harassment from students.

Method: Nursing academics in Universities in the United Kingdom, which provided undergraduate nursing programmes, were invited to complete an online questionnaire; an introductory letter and participant information sheet was provided. A 41-item Likert scale (strongly agree-strongly disagree) was used to elicit academics’ experiences of contra-power harassment and their views regarding possible contributing factors.

Results: The responses from UK academics indicated that students were disrespectful and demanding in their written communications; that they challenging academic integrity; and they expected to be coached more to gain a higher degree classification. This mirrored the Australian responses [1] which indicated that inappropriate behaviour was related to consumerism of higher education and a sense of entitlement from students as they paid for a degree and that academics experiencing the highest levels of student harassment related to assessment grades.

Conclusions: Incivility, poor and demanding behaviour is becoming more common place in higher education and this is causing academics to question their own interactions and understanding of student psychology and culture and the need to develop coping strategies. Appreciation of the risk factors of poor behaviour can aid academics in ensuring that not only is there an appropriate harassment prevention policy but that the implementation of appropriate prevention strategies is in place.

Highlights

• Students harass academics to try to gain a higher grade in their academic work.
• Students demonstrate poor language skills in electronic communications.
• Undergraduate students’ uncivil behaviour is affecting academics.

Keywords

Harassment, Incivility, Contra-power, Student nurses

Introduction

Research is showing that violence in society is increasing and can cause suffering and ruin lives. Socially aggressive behaviour can occur across the life span and is where individuals may be irritable, impulsive, angry and violent; accordingly, individuals will be more aggressive due to developmental transitions, a range of medical and / or psychiatric diagnoses [2]. Whilst not everyone may be subjected to violent behaviour literature suggesting that unsociable behaviour is increasing, and that it is shaped by society, led to the City University of London establishing The Violence and Society Centre (2019) [3], it’s aim to ‘produce the evidence to build the theory needed to inform policy, politics and practice to move towards zero violence’. One can suggest therefore that students entering higher education may have been on the receiving end of socially aggressive behaviour, and as such have the potential to demonstrate violent behaviour in the university. They may also demonstrate unacceptable behaviour because they are vulnerable to the newness of the university environment, and/or have a new stressful living environment, and the social pressures of belonging and the need to achieve is great [4]. Research exploring the behaviour of nursing students is showing that they are behaving in an uncivil, aggressive and harassing manner toward academics. Lee [5] and Christensen [1] suggest that poor behaviour is a result of the commercialisation of higher education with it being seen as an economic investment, pay-as-you-go access to a university education. Kopp and Finney [6] discuss how perceptions of academic entitlement has been theoretically linked with uncivil student behaviour. However, entitlement and the reality of higher education are too often incompatible as the effort needed to obtain a degree and the demands of the course are too high for some students to achieve and non-achievement is a threat to investment which manifests itself in poor uncivil behaviour [1,5,7].

Background

Inappropriate, uncivil contra-power harassing behaviour towards academics by students is becoming more common place. Research has focused on different types and potential causes. White [7-9], all identified that contra-power harassment was characterised by verbal, task, personal and isolationist attack. Verbal abuse is reported as being the most common form of incivility and consists of shouting, swearing, inappropriate language or verbally aggressive language, name calling or heckling. Nursing student incivility in the USA identified that the three major disruptive behaviours were inattentiveness in class, attendance problems and lateness [10]; over 40% (n: 409) of respondents identified that they had been subjected to verbal abuse and over 23% being subjected to offensive physical contact / violence which included hitting or slapping. White’s [7] UK research also found that malicious rumour mongering was rife and this is identified as social and emotional abuse. Blizard [8] discusses isolation attack and how this can be students using mobile phones or talking during lessons, or when individual students using the collective voice to air their displeasure and harass.  De Souza & Fansler’s [9] work on contra-power sexual harassment found that personal attack manifested in comments of a sexual nature being written in unit/module evaluations, stalking and in some cases sexual harassment. They found that over 50% of academics had experienced some form of sexual harassment or unwanted sexual attention from students. White’s [10] study described how female academics where the targets of sexual innuendo or seen as sexual objects by male students, and where male academics where offered sexually explicit picture texts as bribery for favourable assessment results. Lashley and DeMeneses [10-13] identified that incivility in nursing students was demonstrated by lateness, inattention, absenteeism, academic dishonesty, verbal abuse, aggressive behaviours (including use of mobile technology). Task harassment was also identified and this included contacting academics outside normal working hours, allegations of bias marking, and fabricating evidence against an academic and character assassination on social media. Other literature which focuses on non-nursing students found similarities [13-18]. Despite workplace bullying and harassment being unlawful in the UK (UK Equality Act 2010) it is still occurring. This is mirrored in the USA by the Workplace Bullying Institute [19] who estimates that one in three employees has been bullied. Lampman [9] found that women in academia reported significantly more negative outcomes as a result of harassment than men as they were more likely to receive threats, episodes of intimidation or bullying from students. It should be noted here that there is a prevalence of females in nurse academia because nursing in the UK is predominantly a female profession (in 2016 only 11.4% were male). Nurses are regulated by the Nursing and Midwifery Council (NMC) – [20] and must abide by the NMC Code of professional conduct (NMC 2018).  This states that nurses must ‘treat people with kindness, respect and compassion’ and ‘recognise diversity’ and ‘respect and uphold people’s human rights’ and as such nurses need to have exceptional communication and interpersonal skills and hold an empathetic disposition. However, there is a national and international scrutiny of healthcare which suggested that nurses, especially nursing students, do not hold the disposition necessary to be a nurse [21]. Phillips [22], and Rosser [23] longitudinal study however showed that student nurse did hold caring values; and Scammell [24] identified that higher education recruitment strategies in the UK upheld a values based selection and admission criteria. Yet Watson [25] suggest that service users, and their families and carers, are dissatisfied with healthcare and that worldwide political influences are impacting on healthcare provision [26-29] is causing discontent. Literature is suggesting that incivility towards academics is becoming a commonly occurring phenomenon and is causing academics to be concerned. Kopp and Finney [6], Lampman [9] and Christensen [1] suggest that part of the reasons for growing incivility is that there is a growing sense of entitlement and a shifting of cultural norms by the present generation of students accessing higher education. Alarmingly Christensen [1] found that students neither concerned nor cared about the consequences of harassing the academics. In Lee’s [5] UK work she highlighted how there is power imbalance in favour of the university student. Indeed, Keashly and Neuman [30] noted that for many academics, caught in the ‘cycle of abuse’, had very little recourse and feared repercussions if not being believed if they spoke out and this left them powerless. Indeed, academics’ being bullied by students is also being reported on in national press] and how the abuse is making staff extremely anxious [31].

Aim

The aim of this study is to better understand the extent to which nursing academics experience contra-power harassment from undergraduate nursing students.

Method, Setting and Sample

A convenience sample of 19 universities across the UK were invited to take part. Heads of nursing departments / Deans of faculties were asked to disseminate an online survey. A participation information sheet outlining the aim of the study, study protocol, ethical approval, what participation entailed and link to the study were emailed to the heads / Deans. Anonymity of the university and respondents was emphasised (Table 1).

Table 1: Participant Demographics (n=17).

Age	36-40	2
	41-45	1
	46-50	5
	51-55	4
	56-60	4
	>60	1
Gender	Female	12
	Male	5
University Faculty	Health	6
	Science & Engineering	2
	Business	4
	Arts & Humanities	1
	Other	3
Academic Level	Associate Lecturer	1
	Lecturer	2
	Senior Lecturer	10
	Principle Lecturer	3
	Associate Professor	1
Years’ Experience	2-5	1
	6-10	1
	11-15	8
	16-20	4
	21-25	1
	26-30	2
Current Work Status	Full-Time	15
	Part-Time	2
Teaching Space	Undergraduate	13
	Post Graduate	4

[NB: 1 participant did not follow through with completing the survey].

Ethics

Ethics approval was sought and granted by the ethics committees in the authors universities (Western Sydney University & Bournemouth University).

Data Collection

Data was collected from November 2018 to May 2019. The Likert scale statements were developed from the literature. For validity a draft survey was sent to five experienced research active nursing academics, after which refinements were made until consensus reached. The survey had three sections 1) demographics, 2) experiences of contra-power harassment and 3) possible contributing factors. Demographic data asked for age, gender, years of academic experience, majority of teaching practice (under-graduate or postgraduate), and academic level. A total of 41 Likert scale statements were included in sections two and three. Section two used a five-point scale ‘never-always’ scale and contained contra-power harassment statements (Table 2). Section three used a five-point scale ‘strongly disagree – strongly agree’ scale with pre-worded statements which focused on perceptions of contributing factors (Table 3).

Table 2: Academics Experiences of Contra-Power Harassment (n=16).

	Scoring: Never (1) – Always (5)	Sometimes N (%)	Often N (%)	Always N (%)	Median (Mean)	Std. Dev
Q1	I feel that when a student complains, their word is believed, whereas I have to justify my actions	3 (18)	5 (31)	3 (18)	3 (3.31)	1.25
Q2	I receive criticism about my student feedback, that is not constructive	4 (25)	4 (25)	–	2 (2.56)	1.09
Q3	I feel my role is less about educating students, and more about me being a provider of marks/grades	6 (37)	5 (31)	2 (12)	3 (3.25)	1.18
Q4	I have had experiences of students being aggressive and disrespectful to me in their response to their marks and grades	10 (62)	2 (12)	–	3 (2.81)	.75
Q5	Students do not take responsibility for their learning, and then insist it’s my fault for not teaching them well enough	8 (50)	6 (37)	–	3 (3.19)	.83
Q6	I feel like retaliating against a student who has been unfairly critical of me, on a personal level	7 (43)	1 (6)	–	2 (2.25)	1.00
Q7	I find students challenge my authority, my experience and my expertise	5 (31)	3 (18)	–	2 (2.56)	.96
Q8	I notice that some students’ expectations of their academic ability are too high or unachievable, and this is reflected in how they communicate with me	5 (31)	8 (50)	–	3 (3.25)	.93
Q9	In my experience, as student expectations of their academic ability increase, so do complaints	5 (31)	7 (43)	1 (6)	3 (3.38)	.89
Q10	I feel powerless to discipline a student who is harassing me	4 (25)	3 (18)	3 (18)	3 (3.00)	1.41
Q11	I have been ‘stalked’ by students when outside of the university physically and/or electronically	3 (18)	–	–	1 (1.56)	.81
Q12	I have had students repeatedly contact me when outside of the normal classroom times, by email or phone messages	3 (18)	6 (37)	–	3 (2.69)	1.25
Q13	I have had students criticise the marks and /or feedback other academics have given them	10 (62)	6 (37)	–	3 (3.38)	.50
Q14	I feel that the student harassment I experience is because students behave unprofessionally with university academics	4 (25)	7 (43)	1 (6)	3 (3.19)	1.17
Q15	I have had students argue about their marks simply because they want a higher grade	4 (25)	7 (43)	–	3 (3.13)	.89
Q16	I have had students complaining about their mark when they have compared their work with other students because they want a higher grade	10 (62)	4 (25)	–	3 (3.13)	.62
Q17	I feel I am being perceived by students not as a knowledgeable expert, but as one who provides a service	6 (37)	4 (25)	1 (6)	3 (2.94)	1.12
Q18	I have been the centre of unfounded student accusations of impropriety of a sexual nature	–	–	–	–	–
Q19	I sometimes engage in displaced aggression against other individuals as a result of student harassment	1 (6)	–	–	1 (1.38)	.619
Q20	I feel angry when students harass me unnecessarily	5 (31)	2 (12)	3 (18)	3 (2.94)	1.39
Q21	I feel scared and fear for my physical safety when a student is verbally aggressive	3 (18)	1 (6)	0	2 (1.88)	.96
Q22	I feel helpless and powerless when students personally attack me on social media	1 (6)	1 (6)	3 (18)	1 (2.27)	1.67
Q23	I am irritated when students actively engage with their electronic devices (e.g. mobile phones, tablets, laptops) in the lesson I’m teaching	4 (25)	5 (31)	2 (12)	3 (3.19)	1.17
Q24	I have been accused of being racist because students are not happy with the mark they have been awarded or don’t feel supported as they would expect	1 (6)	1 (6)	–	1 (1.44)	.89
Q25	I am concerned for my professional reputation when I respond to a student who has harassed me	4 (25)	–	2 (12)	2 (2.31)	1.30

Note: Std Dev – Standard Deviation.

Table 3: Academics attitudes to the contributing factors associated with Contra-Power Harassment.

	Scoring: Strongly Disagree (1) – Strongly Agree (5)	Percentage % (n=16)	Median (Mean)	Std. Dev
Q1	There is a lot of pressure on academics to answer emails from students quickly	75 (12)	4 (4.19)	.98
Q2	Some students write emails that can be misconstrued as abusive and disrespectful because they have poor written language skills	68 (11)	4 (3.63)	.96
Q3	I am distressed when student emails attack me personally and when they are demanding or confrontational	75 (12)	4 (3.75)	1.07
Q4	I believe that consumerism in higher education leads some students to believe that they hold a greater balance of power than the academics	75 (12)	5 (4.31)	1.13
Q5	Sometimes, I am not sure whether it is in my best interests to report student harassment of me to the University	31 (5)	3 (2.88)	1.26
Q6	I feel that students harass academics because students do not have the ability to cope with academic and personal stressors	62 (10)	4 (3.75)	1.00
Q7	Sometimes I feel I have not received support from the University when I report a student’s harassment	24 (3)	3 (2.69)	1.19
Q8	It is usually when assignments or exams are due that I get the most unacceptable behaviour from students	55 (9)	4 (3.38)	1.09
Q9	I believe widening participation has led to increased levels of student harassment of academics	30 (5)	2 (2.81)	1.22
Q10	I believe students hold the view that academics owe them something because they are paying for their degree	81 (13)	5 (4.31)	.94
Q11	The commercialisation of higher education has led to some students being self- absorbed and self-centred, and as a result they are quick to blame others rather than accept responsibility	81 (13)	4 (4.19)	1.05
Q12	The diversity of the student cohort has led to me being harassed more frequently	18 (3)	2 (2.31)	1.20
Q13	When students are unclear or unsure of the programme and/or university requirements, they display more aggressive and unacceptable behaviours	68 (11)	4 (3.88)	.72
Q14	Students today use aggression to exert power over academics	43 (7)	3 (3.25)	1.07
Q15	I believe that there is often a cultural clash when students behave aggressively or inappropriately towards me	62 (10)	3 (2.75)	1.13
Q16	The way some students communicate with me is belittling	37 (6)	2 (2.81)	1.05

Note: The higher the mean the more negatively nursing academics responded; Percentage indicates those that responded either “Agree” or “Strongly Agree”; Std Dev=Standard Deviation.

Data Analysis

Non-parametric testing using Mann Whitney U was used to analyse the demographical data and experiences of and contributing factors associated with contra-power harassment. Cronbach’s-Alpha was also performed to assess internal consistency of the Likert scale statements. Inferential statistics, measures of central tendency and Cronbach’s-Alpha were used to assess consistency of Likert Scale statements. Inductive content analysis was used to identify patterns in the four open ended questions and generic themes identified.

Findings

There were 16 respondents – more females than male. Respondents were lecturer and senior lecturer grades with between 6 and 9 years’ experience of teaching undergraduate students predominantly in Southern England.

Responses to questions which focused on nursing academics experiences of contra-power harassment clearly showed that respondents had experienced harassment from nursing students. Analysis showed 3 main themes: – entitlement, desire for higher grade and societal culture. One of the main forms of harassment related to language skills in the form of poorly written and / or demanding emails from the nursing student and this being supported by harassing emails from their parents.

‘People sometimes forget to say please and thank you before and after a request and this makes the request read like a demand’; ‘Students use words/ comments such as “unfair” or “I am displeased with my mark”. On their own they don’t sound particularly abusive but when it is part of a longer email it all starts to build to feel more threatening’.

‘high achieving parents expect much from their children which can result in the children behaving in unacceptable ways due to the pressure and their parents undertake some bullying behaviour’.

‘More and more parents are getting involved and there can be some very bullying tones’

Another form of harassment related to teaching credibility and challenging academic judgement.

‘They [students] lash out, insult my credibility and teaching content’; ‘I’ve had students challenge my academic judgement (at the time feedback and marks are released) but my feedback is comprehensive and specific’; ‘stating they have not received help or guidance when what is required is covered in lectures, seminars, drop in sessions and 1:1 meetings, but these students are the ones who have not attended’.

‘A group of low performing students pursued a systematic but completely spurious complaint in a very rude and obnoxious manner; one male student was particularly aggressive’.

Responses to questions which asked nursing academics about the contributing factors associated with contra-power harassment clearly showed that most unacceptable behaviour occurred around assessments and the students desire to have a high class degree.

‘I WANT A BETTER MARK’ (capitals denoting shouting) or ‘I want a first’.

‘They are paying therefore they expect to get good marks’.

‘Students pay a lot of money and some believe they are buying a degree’.

‘We always had 60% as a trigger point, e.g. below 60% students were likely to challenge but this has now, over the last 5 years or so, moved to being 70% so now we get challenged is students aren’t given 70%+’.

‘When academic judgement is overturned it makes it appears that despite regulations the student will win’.

‘Grade grabbing has increased and the uni appeals procedure encourages personal attacks’.

The question asking whether widening participation had increased harassment tended to show that academic disagreed, although academics perceived that struggling students expected more help and school attainment had not helped with the independent study needed at university.

‘Schools let students resubmit work until they get a good mark. We don’t. They are frustrated by the lack of a second chance which they are used to’.

‘Students seek coaching rather than guidance’.

‘Often these students appear to have less social skills to cope with criticism – they take it personally and not about the piece of work submitted’.

Other comments indicating societal expectations included sexism and racism:

‘As a female I do feel that sometimes students from the Middle East do not always respect female academics’.

‘As a female and international academic, the wider cohort is more condemning and sceptical of my ability compare to a ‘white British male’ teaching the exact same content’.

‘Respect for academics seems to have gone out of the window with students swearing at academics telling them to ‘F’ off. This seems to happen to the much younger academics where the age differences are small’.

Discussion

The results from this study suggest that undergraduate student nurses are being uncivil towards academics and this takes form in a variety of ways. It is suggested that incivility is due to a societal culture because students feel entitled to more help and an expectation of a higher grade. Findings from this, like others, shows that students harass academics to give them higher grades. Indeed, in the UK universities have been exploring potential grade inflation. Statistics show that the increase has been part of a long term trend and in the early 1990’s about 8% of students achieved a first class degree whereas in 2018 it was 26%, a rise from 18% in 2012 – 2013 (Higher Education Statistics Agency 2018) – [32], and internal audit is subjecting academics to justify the grades given. Research is also highlighting that students are trying to increase their grades by what is now called ‘contract cheating’. It is suggested that as a university education is a commodity, rather than a development of thinking, learning and reasoning, students are buying essays, being dishonest in their essay writing (i.e. parents are writing the essays) and that they do not feel this is wrong [33-36]. The results from this study are not too dissimilar to other research which highlights that student aggression and contra-power harassment is exhibited in a variety of ways. However, what the research is not showing is that UK academics are subjected to constant assessment and one could suggest that tolerance of uncivil behaviour is lessened. In recent years, university managers, leaders and academics have been expected to be responsive to diverse student needs and expectations, a decline in funding, a competitive research environment together with an increase in fiscal accountability. Houston [37] state that ‘meeting challenges to deliver outputs and outcomes is a complex balancing act’ as academics are not only required to balance teaching commitments, income generate, meet research outputs and publishing requirements but they are constantly subjected to internal and external accountability and a number of national measurements’. There are three such measurements. One is the National Student Survey which was introduced in 2005 and is managed by the Office for Students (the independent regulator of higher education in England). This survey assesses undergraduate student’s opinions of the quality of their degree programmes and whilst the results have made institutions take student feedback seriously it has also been used by university managers to discipline staff if scores are low. Another tool is the Research Excellence Framework (REF) which was introduced in 2008 by the Higher Education Funding Council for England (initially called the Research Assessment Exercise and replaced by the REF in 2014). The aim being to produce UK-wide indicators of research excellence providing a quality international benchmark to drive funding and assesses the impact of academic’s research. The third tool, introduced in 2017, is the Teaching Excellence Framework (TEF). This measures excellence in three areas: teaching quality, learning environment and the educational and professional outcomes achieved by students. Consequently, academic are being assessed by internal and external measures and these are key matrices and important consideration for academics applying for promotion and career progression. Positive student feedback in NSS and high scores in TEF and REF are also important in the mandate for supporting university funding. At the same time that academics are being assessed via these national frameworks they are being subjected to excessive demands from students. Student expectations are high and a consumer identity which is being recognised by students are making them demand more from the university [38-40]. Not only is there a growing body of research which shows that academics are being harassed by undergraduates but there is a growing body of research that is showing that horizontal violence (an umbrella term used to describe a range of aggressive behaviours between colleagues) between nurses is as rife [41-48]. Student nurses in the UK spend half of the duration of their programme in practice (2300 hours over three years) and one could suggest that if they are subjected to horizontal violence, or witness to it, and as such they may assume it is ‘normal’ behaviour. For example, research identifies that nurses tolerate low level incivilities, such as condescending tone or gossip or eye-rolling, and consequently student nurses are socialized to accept these behaviours as part of the job and one could suggest that  they may transpose it into the university setting by being uncivil to academics. There is also evidence that academics, despite universities have anti-bullying policies, are being bullied by their employers and that victims pay a high price (such as job loss). The outcome of bullying is often hidden from the public and The Guardian [49] – a renowned British newspaper – reported that in two years UK universities have spent nearly £90m on payoffs to staff who have been subjected to bullying and that as many as 4,000 settlements occurred, some of which are thought to relate to allegations of bullying. However they reported that these payoffs came with “gagging orders”. The British Broadcasting Corporation also undertook an independent survey and identified that ‘Dozens of academics were made to sign Non-Disclosure Agreements after being “harassed” out of their jobs following the raising of’ complaints’ (BBC 2019) [50]. Reports such as this raise fear, stress and reduced motivation for work and one could suggest that this and the constant inspection of their work is preventing staff from achieving high levels of performance. Khan [51-53] systematic review clearly identified that academics that are exposed to the excessive demands of work are subject to burnout resulting in physical and psychological issues and a consequence of this is that universities less productive due to poorly performing academics who have a lower sense of commitment.

Conclusion

There is no doubt that undergraduate students are demonstrating uncivil behaviour that this is having an effect on academics and there are many studies that have looked at the potential causes of this behaviour and its effects on academics. This study has added to the body of knowledge because it specifically relates to undergraduate student nurses and their behaviour towards nurse academics. It is showing that nurse academics are experiencing harassment due to students demands for higher grades and when the students have not achieved they appear to have less social skills in order to cope with the feedback. What has also discussed is a controversial issue which is that academics are less able to manage student behaviour because they are facing constant assessment themselves from internal and external forces. Also this study has suggested that incivility in the nursing profession is acting as role model for student and this is manifesting itself in university.

Study Limitations

This survey was originally sent to academics in the UK, Australia and New Zealand. However, the UK responses were very few in comparison to Australia (n=82) [1] and although the overall findings were not too dissimilar one questioned why responses might have been so few. One might suggest that recent discourse in the UK universities had led to academics being fearful of completing the questionnaire or general disharmony with working life causing anxiety and fatigue, and high workloads do not allow time for participating in research such as this. Of course they may be also suffering from survey fatigue as they are expected to complete returns for REF, TEF and respond to NSS feedback.

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